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Amide proton transfer imaging for differentiation of benign and atypical meningiomas

 Bio Joo  ;  Kyunghwa Han  ;  Yoon Seong Choi  ;  Seung-Koo Lee  ;  Sung Soo Ahn  ;  Jong Hee Chang  ;  Seok-Gu Kang  ;  Se Hoon Kim  ;  Jinyuan Zhou 
 European Radiology, Vol.28(1) : 331-339, 2018 
Journal Title
 European Radiology 
Issue Date
Amides ; Brain/diagnostic imaging ; Differential Diagnosis ; Female ; Humans ; Computer-Assisted/*methods Image Processing ; Magnetic Resonance Imaging/*methods ; Male ; Meningeal Neoplasms/*diagnostic imaging ; Meningioma/*diagnostic imaging ; Middle Aged ; Protons ; Retrospective Studies
Amide proton transfer (APT) ; Chemical exchange saturation transfer (CEST) ; Magnetic resonance imaging ; Meningioma ; Tumour grading
PURPOSE: To investigate the difference in amide proton transfer (APT)-weighted signals between benign and atypical meningiomas and determine the value of APT imaging for differentiating the two. METHODS: Fifty-seven patients with pathologically diagnosed meningiomas (benign, 44; atypical, 13), who underwent preoperative MRI with APT imaging between December 2014 and August 2016 were included. We compared normalised magnetisation transfer ratio asymmetry (nMTR asym ) values between benign and atypical meningiomas on APT-weighted images. Conventional MRI features were qualitatively assessed. Both imaging features were evaluated by multivariable logistic regression analysis. The discriminative value of MRI with and without nMTR asym was evaluated. RESULTS: The nMTR asym of atypical meningiomas was significantly greater than that of benign meningiomas (2.46% vs. 1.67%; P < 0.001). In conventional MR images, benign and atypical meningiomas exhibited significant differences in maximum tumour diameter, non-skull base location, and heterogeneous enhancement. On multivariable logistic regression analysis, high nMTR asym was an independent predictor of atypical meningiomas (adjusted OR, 11.227; P = 0.014). The diagnostic performance of MRI improved with nMTR asym for predicting atypical meningiomas. CONCLUSION: Atypical meningiomas exhibited significantly higher APT-weighted signal intensities than benign meningiomas. The discriminative value of conventional MRI improved significantly when combined with APT imaging for diagnosis of atypical meningioma. KEY POINTS: * APT imaging is useful for differentiating between atypical and benign meningiomas. * Atypical meningiomas exhibited high APT-weighted signal intensity than benign meningiomas. * The diagnostic performance of MRI improved with nMTR asym for predicting atypical meningiomas.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
강석구(Kang, Seok Gu) ORCID logo https://orcid.org/0000-0001-5676-2037
김세훈(Kim, Se Hoon) ORCID logo https://orcid.org/0000-0001-7516-7372
안성수(Ahn, Sung Soo) ORCID logo https://orcid.org/0000-0002-0503-5558
이승구(Lee, Seung Koo) ORCID logo https://orcid.org/0000-0001-5646-4072
장종희(Chang, Jong Hee)
최윤성(Choi, Yoon Seong)
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